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Pediatrics. 2018 Sep;142(3). pii: e20180562. doi: 10.1542/peds.2018-0562.

Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome.

Author information

1
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; mary-margaret.fill@tn.gov.
2
Tennessee Department of Health, Nashville, Tennessee.
3
Department of Health Policy, School of Medicine, Vanderbilt University, Nashville, Tennessee; and.
4
Tennessee Department of Education, Nashville, Tennessee.

Abstract

BACKGROUND:

Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS.

METHODS:

By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3-8 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes.

RESULTS:

A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P < .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P < .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P < .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission.

CONCLUSIONS:

Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.

PMID:
30166364
DOI:
10.1542/peds.2018-0562
[Indexed for MEDLINE]

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